Antisocial Personality Disorder. Antisocial Behaviour –criminal, aggressive behaviour that might...

Antisocial Personality Disorder

Antisocial Behaviour

• Antisocial Behaviour– criminal, aggressive behaviour

that might come to clinical attention

– less inflexible, maladaptive, persistent, distressing, and impairing than APD

Antisocial Personality Disorder

• Pervasive disregard for, and violation of, the rights of others that begins before the age of 15 and continues into adulthood

• 1% of females and 4-6% of males

Antisocial Personality Disorder

• Defining features:– Antisocial behaviour present

before age 15– Irresponsible– Irritable/Aggressive– Impulsive/Reckless– Deceitfulness

Psychopathy

• Late 19th century: “Psychopath”

• 20th century: “Sociopath”

• DSM-IV: “Antisocial Personality Disorder”– not all antisocial behaviour is

evidence of a “disorder”– but fails to include emotional and

interpersonal characteristics associated with psychopathy

APD vs. Psychopathy• Impulsive, but motivated vs.

unmotivated

• Irritable, angry vs. shallow emotions - no empathy or anxiety

• Normal learning vs. poor passive avoidance learning

• Constantly in conflict with society vs. pleasant exterior & deceptive

• reactive aggression vs. instrumental aggression

• Considerable overlap and debate– Clinically antisocial– Simply a criminal– Psychopath

Antisocial Behaviour and Age

• By definition APD individuals demonstrated antisocial behaviour during adolescence

• Homicide rates among boys are much higher in the USA than anywhere else

• Violence has been increasing among children in the USA

Antisocial Behaviour and Age

• Two DSM-IV categories for childhood antisocial behaviour:– Conduct Disorder– Oppositional Defiant Disorder

Antisocial Behaviour and Age

• Antisocial behaviour in childhood is a good predictor of adult antisocial behaviour

• Protective factors– high levels of physiological

arousal– strong orienting response

Sociocultural Approach

• Next to gender, poverty is the single greatest risk factor for violent behaviour

• Injustices in society contribute to the development of criminal behaviour– need and inability to succeed in a

socially sanctioned manner

• Socialization into groups that encourage antisocial behaviour

Behavioural Approach

• Focus on the individuals immediate environment (family)

• Modeling– media, family examples

• Poor reinforcement of pro-social behaviour

• Inconsistent and harsh punishments

• Do not perceive connection between positive behaviour and treatment they receive (luck)

Cognitive Approach

• Poor social problem solving and ability to read social situations

• See hostility where none was intended

Biological Approach

• Identical twins are more likely than fraternal twins to be concordant in criminal activity

• Adopted twins separated at birth are more likely to be concordant with each other than with adopted siblings

Biological Approach

• APD shows high comorbidity with addictions

• General vulnerability to toward antisocial behaviour, not violence

• EEG abnormality in left frontal lobes

Biological Approach

• Limited capacity for fear

• Poor fear conditioning

• Underaroused stimulus-seekers– heart rates at age 3 predict

aggression at age 11

• Anderson, Bechara, Damasio, Tranel and Damasio (1999) Impairment of social and moral behaviour related to early damage in human prefrontal cortex– impaired social behaviour,

insensitivity to consequences of decisions, defective autonomic responses to punishment

– defective social and moral reasoning (but normal intelligence)

• Raine, Lencz, Bihrle, LaCasse, and Colletti (2000) Reduced prefrontal gray matter volume and reduced autonomic activity in antisocial personality disorder– people with APD who do not

have discernable brain trauma nevertheless have subtle prefrontal deficits

– this my explain low arousal, poor fear conditioning, lack of conscience, and decision-making deficits

Psychodynamic Approach

• Traditional psychoanalytic approaches– poor SuperEgo development